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Breaking taboos to better detect breast cancer in black and racialized women

“I’m a three-time breast cancer survivor,” says breast cancer survivor Natalie Wilson. Of Jamaican origin and aged 52, this mother of three was diagnosed in 2008.

During this first diagnosis, the fear of seeing the disease spread to her second breast pushed her to opt for a double mastectomy.

I chose to have a double mastectomy out of fear that the disease would spreadshe explains. Unfortunately, in 2016, the cancer returned in her nipple, requiring two more surgeries. It was a terrifying moment, but I understood that vigilance is essentialshe said.

Why does aggressive breast cancer affect black women more?

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Dr. Abhenil Mittal points out that high breast density is a significant risk factor for the development of cancer.

Photo : Radio-Canada / Déborah St-Victor

Aggressive breast cancer, especially the triple negative type, disproportionately affects black women. Recent research reveals a genetic link between African ancestry and this form of cancer, according to Dr. Abhenil Mittal, an oncologist at the Shirley and Jim Fielding Cancer Center in Sudbury.

Although the precise reasons for this prevalence are not yet fully understood, the combination of complex genetic, environmental, and biological factors appears to contribute to the increased prevalence of aggressive breast cancer in black women.

Women with higher breast density have difficulty detecting tumors during mammography screenings because small cancerous lesions can be obscured by dense tissue.he explains.

Should we approach breast cancer differently in black or racialized communities?

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Photo of Natalie Wilson’s breast after breast reconstruction in 2018.

Photo : Natalie Wilson

Natalie Wilson highlights the silence surrounding breast cancer, particularly present in black communities, which inhibits awareness and acceptance of the disease.

It is essential to talk about this desire for reconstruction, because every woman has the right to her body and her image.

A quote from Natalie Wilson, three-time breast cancer survivor

She had to face the taboo of breast reconstruction, stating: I was made to feel like I shouldn’t want to get back the breast I had lost. This stigma creates pressure on women, making them guilty of wanting to return to their pre-illness appearance.

She emphasizes the importance of addressing this need: It is essential to talk about this desire for reconstruction.

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Alicia Vianga, founder of the After Breast Cancer association, notes that breast cancer, often perceived as a disease of the elderly, deters many young women from being screened, thus leading to late diagnoses.

Photo : Radio-Canada / Déborah St-Victor

Alicia Vianga, founder of the After Breast Cancer association, also denounces the prejudices surrounding cancer in black communities.

She points out that some people think it’s a female disease, but cancer makes no distinction between woman, man or childcalling for increased awareness around this disease, particularly among black men. She cites Beyoncé’s father, breast cancer survivor Mathew Knowles, as an inspiring example.

It also addresses the shame associated with illness, seen as punishment for past mistakes, which can lead to isolation. Often, sufferers wonder what they did wrong, preventing them from speaking to family or friends for fear of judgment.she specifies.

This is completely false. They did absolutely nothing wrong to get breast cancer.

A quote from Alicia Vianga, founder of the After Breast Cancer association

Dr. Mittal, who treats women from diverse cultural backgrounds, also observes that some prefer natural remedies instead of medical treatments, which can delay screening and make the condition worse.

Early detection: an imperative for women particularly at risk

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Natalie Wilson, 52, a proud survivor and mother of three, continues to inspire other black women. “The scars of the fight against breast cancer are a testament to the strength and resilience of survivors,” she says.

Photo : Radio-Canada / Déborah St-Victor

Natalie Wilson points out that her story illustrates a worrying trend: breast cancer is affecting more and more people under the age of 50. In Ontario, screening will now be offered from the age of 40, as announced by the Minister of Health, Sylvia Jones. (New window)

Although Ms. Wilson is pleased with the decision, she remains perplexed, having received her first diagnosis at age 35, below that limit. The importance of early detection is crucial, especially with the increase in cases among young peopleshe warns.

Knowing that black women often experience early and silent symptoms, the oncologist urges women under the age limit to advocate for themselves and seek medical attention if they experience any abnormalities.

He advises: If you feel anything unusual, do not hesitate to consult your doctor. If your first request is not taken seriously, insist. This is the best way to detect potential problems and avoid late screening.

Underrepresentation of minorities in clinical trials

Dr Mittal emphasizes that the black race is vastly underrepresented in almost all clinical trials, as are other minorities. He explains that several initiatives are underway to remedy this situation, but it remains complex.

It is often difficult to encourage people from racialized communities to participate in clinical trials due to negative cultural beliefs related to experimentationhe observes.

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Juliet Daniel, Cancer Biologist, Highlights Urgent Need to Better Meet Diversity Clinical Research Requirements

Photo : Dr Juliet M. Daniel

Professor Juliet Daniel, a cancer biologist at McMaster University, also addresses the lack of representation of black women in clinical studies. She links this absence to history of systemic racism and highlights that the lack of collection of demographic data on diseases in Canada makes it difficult to identify inequalities.

So we don’t know if there are disparities, not just for Black populations, but for all communities in Canada.

A quote from Juliet Daniel, cancer biologist at McMaster University

According to her, this lack of information represents a major challenge for researchers wishing to improve the health of black populations. She points out that the United States has collected population-based disease data since 1975, allowing it to examine these disparities in more depth.

She also emphasizes the need for increased collaboration, including more Black researchers and doctors for culturally informed decisions.

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